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Test Code HBCAB Hepatitis B Core Total Antibody

Important Note

If positive, IgM specific hepatitis B core antigen will be reflexed

Performing Laboratory

Memorial Hospital Laboratory- Virology Laboratory 304-388-9618

Specimen Requirements

Plasma- 2 EDTA, Lavender Top Tubes

Draw 5 ml of plasma(minimum 3.0 mL plasma) 

Centrifuge and remove plasma within 8 hours of collection

Specimen Rejection

  • Improperly labeled, collected, stored, and transported
  • Quantity not sufficient
  • Hemolyzed 
  • Serum subject to repeat freeze thaw cycles.

Storage and Stability

Room Temperature Up to 8 hours
Refrigerate > 8 hours prior to testing
Freeze > 5 days before testing

Reference Values

Negative: No antibody to hepatitis B core antigen virus detected

Positive:  Antibody to hepatitis B core antigen virus detected


Interpretation depends on clinical setting. See Hepatitis Serological Profile Interpretation Guide in Special Instructions.

 

Interpretation of the Hepatitis B Panel

TESTS

RESULTS

INTERPRETATION

HBsAg
anti-HBc
anti-HBs

Non Reactive
Non Reactive
Non Reactive

susceptible

HBsAg
anti-HBc
anti-HBs

Non Reactive
Reactive
Reactive

immune due to natural infection

HBsAg
anti-HBc
anti-HBs

Non Reactive
Non Reactive
Reactive

Immune due to hepatitis B vaccination

HBsAg
anti-HBc
IgM anti-HBc
anti-HBs

Reactive
Reactive
Reactive
Non Reactive

acutely infected

HBsAg
anti-HBc
IgM anti-HBc
anti-HBs

Reactive
Reactive
Non Reactive
Non Reactive

chronically infected

HBsAg
anti-HBc
anti-HBs

Non Reactive
Reactive
Non Reactive

Four interpretations possible*

*1. May be recovering from acute HBV infection
  2. May be distantly immune and test not sensitive enough to detect very low level of anti-HBs.
  3. May be susceptible with a false positive anti-HBc.
  4. May be undetectable level of HBsAg present in the serum and the person is actually a carrier.

Methodology

Chemiluminescence immunoassay

CPT Coding

86704

Days Test Set Up and Turnaround

Monday through Friday, Continuously

Weekends and Holidays, Batched once per day

Results available same day as testing performed

Additional Information

SIGNS & SYMPTOMS: About 30% of persons have no signs or symptoms. 
Signs and symptoms are less common in children than adults. These may include: 
jaundice; fatigue; abdominal pain; loss of appetite, nausea, vomiting; and/or joint pain.

LONG-TERM EFFECTS WITHOUT VACCINATION: Chronic infection occurs in: 
· 90% of infants infected at birth ; 30% of children infected at age 1 - 5 years ;6% of persons infected after age 5 years ;  Death from chronic liver disease occurs in 15-25% of chronically infected persons

TRANSMISSION: Occurs when blood or body fluids from an infected person enters the body of a person who is not immune. HBV is spread through having sex with an infected person without using a condom (the efficacy of latex condoms in preventing infection with HBV is unknown, but their proper use may reduce transmission), sharing needles or "works" when "shooting" drugs, through needlesticks or sharps exposures on the job, or from an infected mother to her baby during birth. Persons at risk for HBV infection might also be at risk for infection with hepatitis C virus (HCV) or HIV.

RISK GROUPS:
· Persons with multiple sex partners or diagnosis of a sexually transmitted disease; Men who have sex with men ; Sex contacts of infected persons; Injection drug users; Household contacts of chronically infected persons; Infants born to infected mothers; Infants/children of immigrants from areas with high rates of HBV infection; Health care and public safety workers; Hemodialysis patients

PREVENTION: Hepatitis B vaccine is the best protection. If you are having sex, but not with one steady partner, use latex condoms correctly and every time you have sex. The efficacy of latex condoms in preventing infection with HBV is unknown, but their proper use may reduce transmission. If you are pregnant, you should get a blood test for hepatitis B; Infants born to HBV-infected mothers should be given HBIG (hepatitis B immune globulin) and vaccine within 12 hours after birth. Do not shoot drugs; if you shoot drugs, stop and get into a treatment program; if you can't stop, never share needles, syringes, water, or "works", and get vaccinated against hepatitis A and B. Do not share personal care items that might have blood on them (razors, toothbrushes, nail clippers). Consider the risks if you are thinking about getting a tattoo or body piercing. You might get infected if the tools have someone else's blood on them or if the artist or piercer does not follow good health practices. If you have or had hepatitis B, do not donate blood, organs, or tissue. If you are a health care or public safety worker, get vaccinated against hepatitis B, and always follow routine barrier precautions and safely handle needles and other sharps.

VACCINE RECOMMENDATIONS
· Hepatitis B vaccine available since 1982 ; Routine vaccination of 0-18 year olds; Vaccination of risk groups of all ages

TREATMENT & MEDICAL MANAGEMENT
HBV infected persons should be evaluated by their doctor for liver disease. Adefovir dipivoxil, alpha interferon, and lamivudine are three drugs licensed for the treatment of   persons with chronic hepatitis B. · These drugs should not be used by pregnant women. Drinking alcohol can make liver disease worse.

TRENDS & STATISTICS
· Number of new infections per year has declined from an average of 260,000 in the 1980s to about 78,000 in 2001.  Highest rate of disease occurs in 20-49-year-olds. Greatest decline has happened among children and adolescents due to routine hepatitis B vaccination. Estimated 1.25 million chronically infected Americans, of whom 20-30% acquired their infection in childhood.
For additional information, please refer to the Centers for Disease Control and Prevention at CDC.gov.